SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT

FOR

DISSERTATION

Mrs. ANN MARIA JOSE

FIRST YEAR M.SC (NURSING)

COMMUNITY HEALTH NURSING

YEAR 2011-2013

INDIAN ACADEMY COLLEGE OF NURSING

HENNUR CROSS

BANGALORE – 560043

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

1

BANGALORE, KARNATAKA

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT

FOR DISSERTATION

1. NAME OF THE CANDIDATE AND ADDRES

Mrs. ANN MARIA JOSE1ST YEAR M.Sc (NURSING)INDIAN ACADEMY COLLEGE OF NURSING,HENNUR CROSS, BANGALORE – 560 043

2. NAME OF THE INSTITUTION INDIAN ACADEMY COLLEGE OF NURSING, BANGALORE-560043

3. COURSE OF THE STUDY AND SUBJECT

1ST YEAR M.Sc (NURSING), COMMUNITY HEALTH NURSING

4. DATE OF ADMISSION TO THE COURSE 02/11/2011

5. TITLE OF THE STUDY“A STUDY TO ASSESS THE EFFECTIVENESS OF INFORMATION BOOKLET ON KNOWLEDGE REGARDING NUTRITIONAL DEMANDS DURING PREGNANCY AMONG ANTENATAL MOTHERS IN SELECTED RURAL AREAS AT BANGALORE.”

6. BRIEF RESUME OF THE INTENDED WORK

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INTRODUCTION

“Health of pregnancy is wealth of the Nation. There is chance for the welfare

of the world only when the condition of women improves.”

-Swami Vivekanandan

We normally think of our nutrition as personal, affecting only our own lives. This

isn't always the case though. The woman who is pregnant, or who may be, must

understand that her nutrition today will be critical to the health of her child throughout

life. The nutrition demands of pregnancy are extraordinary because the growth of a whole

new person requires all the minerals and other nutrients, and most in larger amounts.1

During pregnancy, a woman must establish nutritional habits that will optimally

nourish both the growing fetus, and herself. She must be well nourished at the outset

because in early pregnancy the embryo undergoes rapid and significant developmental

changes that depend on her prior balance of minerals, vitamins, and other dietary

concerns. Fathers-to-be are also encouraged to consider their nutrition status.1

Pregnant mother should eat three meals a day with a few snacks to keep blood

sugars stable and accommodate for the limited room stomach has to expand as the baby

grows. Eating smaller, more frequent meals also helps to manage nausea during the first

trimester. She should not diet or limit carbohydrates or fats or be on any type of

restrictive diet, unless recommended by your doctor. Pregnant mother need the calories

and fat in a well-balanced diet to feed the growing fetus. If it might be hard to eat a well-

balanced diet, try to get enough calories and fluids and take your prenatal vitamin.

3

The demands of pregnancy necessitate additional dietary requirements.

Obviously, additional energy (caloric) intake is required to support recommended weight

gain. Because energy requirements in pregnancy are increased by 17% over the non-

pregnant state, a woman of normal weight should consume an additional 126 kJ/d (300

kcal/d. A sample diet for normal pregnancy is based on the food pyramid and should

include 6-11 servings of grains; 3-5 servings of vegetables; 2-4 servings of fruit; 3-4

servings of dairy; 2-3 servings of meats, beans, or nuts; and 1 serving of sweets. Total

energy intake should vary by BMI, but the average recommendation is 10,460 kJ/d (2500

kcal/d).3

The average weight gained by healthy pregnant eating without restriction is 12.5

kg (27.5 lb). This weight gain represents two major components: 1) the products of

conception: fetus, amniotic fluid and the placenta and 2) maternal accretion of tissues:

expansion of blood and extracellular fluid, enlargement of uterus and mammary glands

and maternal stores (adipose tissue).4

Current recommendations for weight gain during pregnancy

Weight-for-height category Recommended total gain, kg (lb)

Low (BMI < 19.8) 12.5–18 (28–40)

Normal (BMI 19.8–26.0) 11.5–16 (25–35)

High (BMI > 26–29) 7–11.5 (15–25)

Low weight gain is associated with increased risk of intrauterine growth

retardation and perinatal mortality. High weight gain is associated with high birth weight

4

and secondarily with increased risk of complications related to fetopelvic disproportion.

Current recommendations for weight gain during pregnancy are higher for thin women

than for women of normal weight and lower for short obese women. Water-Soluble

nutrients and metabolites are present in lower concentrations in pregnant than in

nonpregnant women whereas fat-soluble nutrients and metabolites are present in similar

or higher concentrations.5

Nutrition in the womb is the process that delivers to the fetus what it needs to

grow and develop into a healthy baby. A fetus receives its nutrition from two sources.

The first source of nutrients is from the mother’s diet before and during pregnancy. Most

people understand this.6

The least known and probably more important source of nutrients is the mother’s

body. All bodies undergo a turnover process. Turnover is the ever-changing state of

breakdown and renewal of muscle, fat and bone which releases protein, fat and calcium

into the bloodstream. In a pregnant woman these nutrients are important sources of food

for a growing baby. Mothers who have good turnover rates for themselves are able to

provide well for their babies. A mother acquires her body composition and turnover

throughout her whole lifetime as a fetus, child, girl, adolescent and adult. The mother’s

turnover and her diet work in harmony to provide nutrition in the womb through the

placenta.6

Our knowledge on the effect of maternal dietary adequacy for the success of

pregnancy is far from complete as is the role that dietary supplement may play. Birth

weight and infant growth measures are the principal indicators of reproductive success

used in scientific studies. This understanding is essential for the development of

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meaningful public health policies and recommendations directed at reproducing women

for ensuring appropriate nutrient intake from food and the safe and effective use of

dietary supplements for nutrients that are limited in the maternal diet. In this study the

physiological adjustments and nutritional requirements of pregnant women and the

possible role of dietary supplementation in meeting requirements for nutrients likely to be

limiting in the diet are discussed.6

6.1 NEED FOR THE STUDY

I found good evidence linking poor maternal nutrition to several leading causes of

infant mortality, including birth defects, preterm birth, fetal growth restriction, and

maternal complications of pregnancy (preeclampsia, anemia, infections/ inflammation).

Maternal foliate and B12 deficiencies have been associated with neural tube defects,

while deficiencies in B vitamins, vitamin K, magnesium, copper, and zinc have also been

linked to other birth defects. Low pre-pregnancy body mass index (BMI) and poor

gestational weight gain are associated with greater risk for preterm birth and fetal growth

restriction.5

Maternal nutrition can also mediate or modulate several of the major pathways

(e.g., inflammatory) leading to spontaneous preterm birth. While the contribution of

specific nutrient deficiencies to preeclampsia remains unclear, maternal nutrition can

potentially play an important role in the pathogenesis of preeclampsia by affecting

endothelial function, ameliorating oxidative stress, modulating inflammatory response,

and improving insulin action. In light of the importance of abnormal implantation and

placentation in the pathogenesis of preeclampsia, periconceptional nutrition may be of

6

paramount importance. Nutritional deficiencies of iron, foliate, and vitamins A, B6, and

B12can cause anemia. Vitamin A and other micronutrient deficiencies have been

implicated in maternal infections, and antioxidants can potentially play a major role in

modulating inflammation and oxidative stress from maternal infections. The growing

body of research on fetal programming of adult diseases further elevates the clinical and

public health significance of maternal nutrition.7

A poor pregnancy diet can lead to various nutritional deficiencies. During

pregnancy, you need plenty of folic acid, calcium and iron. Kids Health indicates that

pregnant women will need to exceed the usual 1000 mg of calcium recommended for

adult women.8 This is to ensure that your body's needs are not compromised in order to

meet the calcium needs of the baby. Iron is important because your body needs it to make

the hemoglobin that transports oxygen to your body and to your fetus. Folic acid prevents

your fetus from developing defects of the spine and spinal cord. A prenatal vitamin will

fill in nutritional gaps, but it is always best to get your vitamins and minerals from whole

foods.9

Indian Information

In India nearly 20 % of pregnancies end in miscarriages, premature births and

soon infant mortality is also very high 75/ 1000 live births in 2007 due to poor

nourishment of mothers which in turn leads to poor health and resistance towards

diseases in the newly born child.10

The government of India introduces various nutritional programs in its policy

from time to time. Most of these are supplementary nutrition programs are like mid-day

7

meal program, Balwadi nutrition Program, nutritional vitamin A prophylaxis program

and nutritional anemia control program. To be effective, the nutritional programs should

be comprehensive and emphasize upon improvement in general health and quality of life

of population, control of infections and effective nutritional education besides provision

of nutritional supplementation.10

Women in developing countries are always in a state of precarious iron balance

during their reproductive years. Their iron stores are not well developed because of poor

nutritional intake, recurrent infections, menstrual blood loss, and repeated pregnancies.

Gender discrimination in a country like India results in girls lacking access to a balanced

diet, adequate healthcare, and proper education. Thus the average Indian woman enters

her reproductive years, and particularly pregnancy, with iron and foliate deficiency.10

In India During the first 2 trimesters of pregnancy, iron-deficiency anemia

increases the risk for preterm labor, low-birth-weight babies, and infant mortality and

predicts iron deficiency in infants after 4 months of age. It is estimated that anemia

accounts for 3.7% of maternal deaths during pregnancy. Therefore it is important to

diagnose and treat anemia to ensure the optimal health of the mother and the newborn.10

In Indian nearly 73.5, 2.7, 43.6, 73.4, 26.3, and 6.4 percent PW were deficient in

zinc, copper, magnesium, iron, folic acid and iodine, respectively. The highest concurrent

prevalence of two, three, four and five micronutrient deficiency was of zinc and iron

(54.9%); zinc, magnesium and iron (25.6%); zinc, magnesium, iron and folic acid (9.3%)

and zinc, magnesium, iron, folic acid and iodine (0.8%), respectively. No pregnant

woman was found to have concomitant deficiencies of all the six micronutrients. Dietary

intake data revealed an inadequate nutrient intake. Over 19% PW were consuming less

8

than 50% of the recommended calories. Similarly, 99, 86.2, 75.4, 23.6, 3.9 percent of the

PW were consuming less than 50% of the recommended folic acid, zinc, iron, copper,

and magnesium. The consumption of food groups rich in micronutrients (pulses,

vegetables, fruits, nuts and oil seeds, animal foods) was infrequent. Univariate and

Multivariate logistic regression analysis revealed that low dietary intake of nutrients, low

frequency of consumption of food groups rich in micronutrients and increased

reproductive cycles with short interpregnancy intervals were important factors leading to

micronutrient deficiencies.11

In recent years, different Government programs like ICDS, MCH etc, have been

introduced to improve the nutritional status of women. National Nutritional Anemia

Prophylaxis Program (NNAPP) was initiated in 1970 with the aim to bring down

prevalence of anemia to 25% (National Nutritional Policy, IX Plan). The daily dosage of

elemental iron for prophylaxis and therapy has been increased to 100 mg & 200 mg

respectively under Child Survival and Safe Motherhood Program (CSSM).12

Worldwide information

In the United States, approximately 300-500 women die every year from giving

birth, 11% of infants are born too early, 7.4% have low birth weight, and 7 of every 1000

live births die within the first year of life. These are stunning statistics; however, there are

many things an expectant mother can do to reduce these statistics, so they recommended

the following during pregnancy (Grosvenor & Smolin, 2006).13

9

The first trimester does not see a significant increase in calorie expenditure, but

the second and third trimester energy and nutrition needs would be met by eating

a second lunch or breakfast daily.

During the second trimester, calories should be increased by an additional 340

calories per day;

During the third trimester, calories should be increased by an additional 452

calories per day. Protein is responsible for new cell building, so pregnant woman

need an additional 25 grams of protein daily during the second and third

trimesters.

According to the Food Guide Pyramid, pregnant women need one additional

serving of milk, vegetables, meat, and bread, with no increase in fruit servings for

a 25 year old woman. (Grosvenor & Smolin, 2006)

Due to the increase in blood volume, the creation of amniotic fluid, and

prevention of constipation, which equals around six to nine liters of water, water

needs increase from 2.7 liters to 3 liters a day (including the water received from

food).

Vitamin and mineral needs increase during pregnancy; needs are usually met

through increases in dietary consumption and supplementation. 

Roughly 47% of non-pregnant women and 60% of pregnant women have anemia

worldwide, and including iron deficiency without anaemia the figures may approach 60

and 90% respectively. In the industrial world as a whole, anemia prevalence during

10

pregnancy averages 18%, and over 30% of these populations suffer from iron deficiency.

The poor are more affected.11

According to WHO, in developing countries, the prevalence of vitamin deficiency

among pregnant women is 56% (WHO, 1992). The prevalence of vitamin deficiency in

India is 60 -70% (Park, 2005).12

The family and community will feel satisfied and secured life when the women take

initiative in caring themselves. So that, the women should have appropriate and adequate

knowledge on nutritious diet, exercise and minor ailment occurs during pregnancy.

Hence, the investigator planned to conduct a study to improve their knowledge on

nutritional demand to promote health during pregnancy.

11

6.2 REVIEW OF LITERATURE

According to Burns (1997), the literature review is an essential component of the

research as it aids researcher in formulating the research plan. By definition, the review

of literature is broad, comprehensive, in-depth, systematic and critical, audiovisual

material and personal communication. The primary purpose of the literature review is to

give broad background knowledge or understanding of limitation that is available related

to research problem of interest. It is also help the researcher to conduct his or her actual

study. The literature review include both research and non research literature.

For the present study the review of literature is organized under the following

headings.

1 Literature related to knowledge of pregnant mothers regarding

nutritional requirements during pregnancy.

2 Literature related to importance of adequate nutrition among

pregnant mothers.

3 Literature related to the effectiveness of educational programmes on

nutritional requirements among pregnant mother.

I. Literature related to knowledge of pregnant mothers regarding

nutritional requirements during pregnancy.

Fowles, Eileen R, (2007), conducted a study for Comparing Pregnant Women's

Nutritional Knowledge to Their Actual Dietary Intake. The purpose of this study was to

12

describe differences between low-and middle-income pregnant women's general

nutritional knowledge, usual dietary intake and weight gain. A descriptive design

employing a questionnaire with a convenience sample of women (N = 109) from both

childbirth education classes and a free prenatal clinic. This study concluded that most

women had inadequate general nutritional knowledge, and their dietary intake did not

meet all the nutritional requirements of pregnancy.14

Abdulbari Bener, (2006) conducted a study on maternal knowledge, attitude and

practice on dietary demands among Arabian Qatari women. The aim of this study was to

determine the level of knowledge about the dietary demands during pregnancy in a

sample of women in the child-bearing age. A multistage sampling design was used and a

representative sample of 1800 Qatari women aged between 18 and 45 years were

surveyed during the period June to November 2004. One thousand four hundred and

eighty women (82.2%) expressed their consent to participate in this study. Educated

women were aware of the importance of the dietary intake during pregnancy. The study

findings suggested possible avenue for intervention to increase awareness and dietary

intake during pregnancy.15

Michael J Dibley, (2009) conducted a study to assess the knowledge regarding

dietary intake among pregnant women in a rural area of western China. 1420 pregnant

women were recruited from rural area of western China. Information was collected at the

end of their trimester with an interviewed-administrated semi-quantitative food frequency

questionnaire (FFQ). These results reveal that the majority of pregnant had inadequate

knowledge regarding dietary intakes of nutrients that are essential for pregnancy.16

13

LIU Dong-ying, WANG Lin-jing, (2007), conducted survey and analysis on

nutritional knowledge, attitude and practice of pregnant women in Guangzhou. The

objective of the study was to to investigate the levels of nutritional knowledge, attitude

and practice(KAP)of pregnant women in Guangzhou and the influencing factors, so as to

provide scientific evidence for developing nutrition education programs for pregnant

women in future. A questionnaire survey about nutritional knowledge, attitude and

practice(KAP)was carried out among 169 pregnant women in two hospitals of

Guangzhou. Most subjects lacked a overall understanding of nutritional knowledge and

had some unhealthy dietary practices. However, they held a positive attitude towards

nutrition, and desired to acquire more knowledge of nutrition and health. It is suggested

that more nutrition education should be implemented by taking acceptable measures for

pregnant women and their families, so as to make them know more nutritional knowledge

and take healthy dietary practices.17

Mahmood S, (2010), conducted a study to assess the nutritional knowledge and

practices in pregnant and lactating mothers in an urban and rural area of Pakistan.

Nutritional knowledge and practices in 100 pregnant and 100 lactating women were

assessed in an urban and rural area of Lahore. A structured questionnaire was used for the

purpose. Eight-four percent of mothers had knowledge that diet should be changed by

increasing, adding or avoiding some special food items in the diet during pregnancy and

lactation, but only 65.5% practiced them. The reasons for this deficient knowledge and

practice of dietary intake are lack of nutritional knowledge and poor economy. This study

concluded that improving nutritional knowledge and dietary practices of population in

14

general and vulnerable groups in particular through media and MCH services on the use

of locally available low cost nutritious foods and to avoid undue food restrictions.18

Jassie .S (2010), “ A descriptive study was done on Knowledge and attitude of

pregnant mothers regarding diet during pregnancy among 75 pregnant mothers in

selected maternity centers of Madurai “ . Researcher used structured interview schedule

and Likert attitude scale to assess the Knowledge and attitude of mothers. Researcher

found out that 36 (48 % ) of mothers had inadequate knowledge and 39 ( 62 %) of

mothers had adequate knowledge. 38 ( 50.6 % ) of mothers had unfavorable attitude and

37 ( 49.4 % ) of mothers had favorable attitude towards pregnancy diet. High positive

correlation found between knowledge and attitude scores of mothers about diet during

pregnancy. Significant association ( P < 0.01) was found between knowledge score of

mothers with their education and family monthly income . Significant association ( P <

0.01 ) was found between attitude score of mothers with their education and previous

breast feeding experiences.19

II. Literature related to importance of adequate nutrition among pregnant

mothers

Paul, A.A (2008) , studied that The importance of maternal dietary energy intake on

pregnancy and lactation in rural Gambian women. Maternal weight gain and the

accumulation of subcutaneous fat were significantly lower when the last trimester of

pregnancy fell during the time of heaviest farm work and lowest energy intakes. The

birth-weight of babies was also significantly correlated with differences in energy intake

throughout the year. During early lactation breast milk yields were significantly related to

same alterations in the subcutaneous fat stores. Undernourished nursing women there

15

could be a competition for dietary energy between the depleting maternal subcutaneous

fat organs and the mammary glands at the expense of milk production.20

Saccomandi, D (2009), conducted study regarding Importance of dietary

supplements for the pregnant mother: influence on the trace element content of milk.

Milk production is a complex process where nutritional factors interact with structural

hormonal and behavioral influences. The study was carried out on women living in

Ferrara and its surrounding area. 32 women were selected and 22 completed it. The effect

of dietary zinc, copper and iodine supplements on the milk concentration of these

micronutrients was studied. The present results indicate that in healthy, well-nourished

women, whose diet is adequate, the levels of zinc, copper and iodine in milk are not

influenced by short-term supplementary intakes and that the milk levels of the trace

elements studied are maintained over different levels of intake.21

16

Fiona Mathews, (2009) conducted a study to assess the importance of

maternal nutrition on outcome of pregnancy. The objective of the study was to

assess the importance of maternal diet during pregnancy. 693 pregnant nulliparous

white women with singleton pregnancies who were selected from antenatal booking

clinics with stratified random sampling. This study concluded that maternal

nutrition had important effects on the placental or birth weight of infants born at

term.22

Carlos A Camargo, (2007) conducted a study to assess the importance of

maternal intake of vitamin D during pregnancy. The participants were 1194 mother

in Project Viva—a prospective pre-birth cohort study in Massachusetts. We assessed

the maternal intake of vitamin D during pregnancy from a validated food-frequency

questionnaire. The result of the study showed that higher maternal intake of

vitamin D during pregnancy may decrease the risk of recurrent wheeze in early

childhood.23

III. Literature related to the effectiveness of educational programmes on

nutritional requirements among pregnant mother.

Maxwell J, (2010) conducted a randomized community intervention trial to increase

awareness and knowledge of the dietary requirements in women of child-bearing age.

1197 women interviewed prior to the intervention, they were selected from Local

Government Areas in the state of Victoria, Australia. Only 70% of women who were

aware of dietary intake during pregnancy. Printed information recommending dietary

intake to decrease the risk nutritional deficiency was disseminated to women of child-

17

bearing age. The result of the study suggested that the provision of printed educational

material can increase awareness of nutritional demands among women of child-bearing

age.22

W. L. Wrieden, (2009), conducted a study to assess the effectiveness of nutrition

education intervention programme for pregnant teenage women. An intervention was

designed incorporating seven informal food preparation sessions, which allowed

opportunities for discussion of nutritional, and other topics (e.g. food safety and well-

being in pregnancy). Midwives in a community centre setting led the sessions. The result

of the study concluded that the nutrition education programme was effective in increasing

their knowledge regarding nutritional intake during pregnancy.23

Andrew G Symon, (2008) conducted a qualitative study of pregnant teenagers’

perceptions of the acceptability of a nutritional education intervention. The aim of the

study was to assess the feasibility of nutritional education intervention sessions for

pregnant teenagers. 100 pregnant teenagers aged 16–18 years selected from two

community centres and one maternity unit in Tayside, Scotland. Data were collected

using semi-structured tape-recorded group interviews. This study suggested that

nutritional education programme of pregnant teenagers was effective in increasing their

knowledge on nutritional demands during pregnancy.24

AG Kafatos, (2011) conducted a study to assess the effects of an educational

intervention on nutrition during pregnancy in Greece. An intervention program was

undertaken to assess dietary habits and improve the knowledge regarding nutritional diet

among pregnant women in the rural county of Florina, northern Greece. The results

18

indicate that nutrition counseling during pregnancy can improve dietary intake and

maternal weight gain.25

Gholam Reza Sharifirad, (2010) conducted a study to assess the effectiveness of

Nutrition Education Program on nutritional requirements during pregnancy. In this quasi-

experimental controlled study, 110 pregnant women referred to urban health centers in

Gonabad in 2009 were included in two case (54) and control (56) groups. Pre-test data

was collected in two studied groups during their first pregnancy care visit by a self-

administrated questionnaire. The intervention was two educational sessions in case and

control groups based on nutritional diet and Post-test data was collected in the last

pregnancy care visit. This study proved that the nutritional education was successfully

effective to increase their knowledge regarding nutritional requirements during

pregnancy.26

Shwete Joshi. ( 2008 ), conducted a study on “A study to determine the effectiveness

of planned health teaching on Knowledge related to nutritional requirements among

pregnant mothers”. The research approach used for this was quasi experimental . Non

probability convenient sampling was used . The sample size was 50 pregnant mothers.

The pretest knowledge score was 57.4% and the post test score was 80.94%. Significant

difference ( p value > 0.05 ) between pretest and post test score was statistically tested

using paired ‘t’ test and it was found significant ( t=22.6). There was highly significant

association between pretest knowledge score and mother’s education.27

6.3(A) STATEMENT OF THE PROBLEM

19

“A study to assess the effectiveness of information booklet on knowledge

regarding nutritional demands during pregnancy among antenatal mothers in selected

rural areas at Bangalore.”

6.3(B) OBJECTIVES OF THE STUDY

To assess the pre-test level of knowledge of antenatal mothers regarding nutritional

demands during pregnancy.

To evaluate the effectiveness of information booklet on nutritional demands during

pregnancy among antenatal mothers.

To compare the pre-test and post test level of knowledge of the antenatal mothers

regarding nutritional demands during pregnancy.

To demonstrate the association between pretest level of knowledge of antenatal

mothers regarding nutritional demands during pregnancy with their demographic

variables.

6.3(C )OPERATIONAL DEFINITION

Assess

It refers to evaluation of desired or intended outcome of the study.

Effectiveness

It refers to the extent to which the information booklet has achieved the desired

outcome.

Information booklet

20

It refers to a structured learning material prepared in Kannada language by the

researcher to provide information regarding nutritional demands to the antenatal mothers.

Nutritional demands

It refers to a preparation intended to supplement the diet and provide nutrients,

such as vitamins, minerals, fiber, fatty acids, or amino acids, that may be missing or may

not be consumed in sufficient quantities in a person's diet.

Antenatal mothers

It refers to a woman who is carrying a developing embryo or fetus within the

body.

Rural area

It refers to areas that are not urbanized, though when large areas are described.

They have a low population density, and typically much of the land is devoted

to agriculture and has less pollution.

6.3(D) RESEARCH HYPOTHESIS

There is a significant difference between pretest and post test level of knowledge

among antenatal mothers after receiving information booklet on nutritional

demands during pregnancy.

There is significant association between pre-test level of knowledge of antenatal

mothers with selected demographic variables.

6.3(E)ASSUMPTIONS

antenatal mothers may have less knowledge on nutritional demands during

pregnancy.

21

Teaching enhances the knowledge of antenatal mothers regarding nutritional

demands during pregnancy.

Gained knowledge by antenatal mothers may influence practice of diet during

pregnancy.

6.3(F) LIMITATION

This study is limited to antenatal mothers residing in selected rural areas at

Bangalore.

This study is limited to antenatal mothers who are willing to participate in the

study.

This study is limited to only 60 antenatal mothers residing in selected rural areas

at Bangalore.

7. MATERIALS AND METHODS

22

This chapter gives a description of the sources of data, research approach,

research design, variables, the setting of the study, population, sampling, research tool,

and methods of data collection and plan for data analysis.

7.1 Sources of data

Data will be collected from antenatal mothers residing in selected rural areas at

Bangalore.

7.2 Methods of data collection

I. Research design

Quasi experimental design is selected in this study.

II. Research approach

One group pre-test post-test approach.

III. Research variables

a. Dependent variables

Knowledge of antenatal mothers regarding nutritional demands.

b. Independent variables

Information booklet regarding nutritional demands during pregnancy among

antenatal mothers.

c. Demographic variables

Characteristics of pregnant mothers such as age, educational status,

socioeconomic status and income.

IV. Setting

Study is planned to conduct in selected rural areas at Bangalore.

V. Population

23

All antenatal mothers residing in selected rural areas at Bangalore

VI. Sample

The antenatal mothers residing in selected rural areas at Bangalore who met inclusion

criteria. For pilot study sample size will be 6. For main study the sample size will be 60.

VII. criteria for sample selection

a) Inclusion criteria

Antenatal mothers residing in selected rural areas at Bangalore.

Antenatal mothers who can communicate freely in Kannada or English.

Antenatal mothers who are willing to participate in the study.

b) Exclusion criteria

Antenatal mothers who are not willing to participate in the study.

Antenatal mother who are having mental illness.

VIII. Sampling Technique

In this study the samples are selected by non probability convenience sampling

technique.

IX. Tool for data collection

The structured questionnaire schedule consists of following sections.

Section A; Demographic proforma includes sample number, age, sex, educational status,

occupation, income and socioeconomic status.

Section B;

24

Questionnaire on knowledge

This consists of questionnaires to assess the knowledge of antenatal mothers

regarding nutritional demands during pregnancy.

X. Methods of data collection

After obtaining permission from concerned authority an informed consent from

samples will be collected and the researcher will collect data from samples.

Phase 1

Pretest will be conducted to assess knowledge of antenatal mothers on nutritional

demands during pregnancy by using a self administered questionnaire.

Phase 2

Information booklet on nutritional demands during pregnancy will be distributed

to the antenatal mothers.

Phase 3

After 1 week post test will be administered to assess the level of knowledge on

nutritional demands during pregnancy to the same subject by using same questionnaire.

Duration of the study will be 4 weeks.

XI. Plan for data analysis

The data will be analyzed by means of descriptive and inferential statistics.

a) Descriptive statistics

Mean, median, mode, standard deviation, percentage distribution, will be used to

assess the knowledge of antenatal mothers on nutritional demands during pregnancy.

b) Inferential statistics

25

Chi-square test will be used to associate knowledge of mothers regarding

nutritional demands during pregnancy with selected demographic variables.

XII. Projected outcomes

After the study, the investigator will able to know the knowledge of antenatal

mothers on nutritional demands during pregnancy. Based on the findings Information

booklets will be given to antenatal mothers. It will help them to improve their nutritional

status during pregnancy period.

7.3 Does the study require any investigation or intervention to the patient or other

human being or animal?

No

7.4 Has ethical clearance been obtained from the concerned authority to conduct the

study?

Yes

a) Permission will be obtained from the Medical Officer of PHC of selected rural

areas at Bangalore.

b) Informed consent will be obtained from the antenatal mothers residing in

selected rural areas at Bangalore to participate in the study with their own

knowledge.

c) The permission will be obtained from the nutritionist for preparing nutritional

requirements during pregnancy.

8. LIST OF REFERENCES

26

1. T. J. Clark, (2008), Pregnancy and Nutrition, Volume: 1, Page No: 68-72,

http://www.tjclarkinc.com/pregnancy_nutrition.htm

2. Bennel V. Rata, Brown Lindak, “Tex book midwives”, (2002), 2nd edition,

Churchil livingstone, London, Pp:755-758.

3. Burbber and Suddarth, “The Lipincott manual of nursing practice”, (2005),

16th edition, J.B. Lippincott company, Philadelphia, Pp:300-350.

4. Mary Frances Picciano, (2003), journal of nutrition, volume- 133, page no.

1997-2002, http://jn.nutrition.org/content/133/6/1997S.full

5. Dutta, “Textbook of Obstetrics”, (2004), 6th edition, New central book agency

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9. Signature of the candidate :

10. Remarks of the guide :

11. Name and designation of

11.1 Guide :

11.2 Signature :

11.3 Co-guide :

30

11.4 Signature :

11.5 Head of the department :

11.6 Signature :

12. Remarks of the Principal :

12.1 Signature :

31